| 液压灌注泵与传统水流冲洗应用于经皮椎间孔镜腰椎间盘摘除术的临床研究 |
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Received:September 15, 2020
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| 期刊信息：《中国骨伤》2021年34卷，第1期，第63-67页 |
| DOI：10.12200/j.issn.1003-0034.2021.01.012 |
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目的：比较液压灌注泵与传统水流冲洗应用于经皮椎间孔镜腰椎间盘摘除术的临床效果。
方法：2016年1月至2018年12月，选择经正规保守治疗无效的腰椎间盘突出症患者72例，以冲洗方法的不同分为液压灌注泵组与传统水流冲洗组，每组36例。两组患者性别、年龄、突出节段、临床分型、术前疼痛视觉模拟评分（visual analogue scale，VAS）及日本骨科协会（Japanese Orthopaedic Association，JOA）评分差异无统计学意义（P>0.05）。所有手术由同一手术者完成，术中分别由液压灌注泵冲洗和传统水流冲洗辅助完成手术。记录两组患者手术时间、术中出血量、住院时间，观察术后VAS和JOA评分，比较术中术后并发症的发生率。
结果：所有患者获得随访，时间12~24（15.7±5.1）个月。与传统水流冲洗组相比，液压灌注泵组的手术时间短[（65.5±21.3） min vs （74.8±19.9） min，t=9.465，P=0.003]，术中出血少[（21.2±12.9） ml vs （27.4±14.1） ml，t=8.331，P=0.012]，但住院时间两组差异无统计学意义。两组患者术后1 d、2周与末次随访的VAS评分及末次随访的JOA评分均较术前改善，但组间比较差异无统计学意义（P>0.05）。传统水流冲洗组术中出现颅内压增高被迫缩短手术时间5例，神经根外膜损伤者4例，术后复发4例，液压灌注泵组术中没有患者出现颅内压增高，出现神经根外膜损伤1例，术后复发2例，液压灌注组并发症发生率低于传统水流冲洗组。
结论：液压灌注泵与传统水流冲洗辅助经皮椎间孔镜手术治疗腰椎间盘突出症均可取得满意的临床疗效，但前者手术时间短、术中视野清晰、出血较少、术中术后并发症少。 |
| [关键词]:经皮椎间孔镜腰椎间盘摘除术 灌洗疗法 病例对照研究 |
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| Clinical study of hydraulic perfusion pump and traditional water flushing for percutaneous endoscopic lumbar discectomy |
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Abstract:Objective: To compare the clinical outcomes of hydraulic perfusion pump and traditional water fhushing in percutaneous endoscopic lumbar discectomy.
Methods: From January 2016 to December 2018,72 patients with lumbar disc herniation failed to conservative treatment were enrolled in this study. The patients were divided into hydraulic perfusion pump group and traditional water flushing group,36 cases in each group. There were no significant differences in gender,age,prominent segment,clinical classification,preoperative visual analogue scale(VAS) and Japanese Orthopaedic Association(JOA) score between two groups(P>0.05). All operations were performed by the same surgeon,and the operations were completed by hydraulic perfusion pump flushing or traditional water flushing assisted surgery. The operation time,intraoperative blood loss,hospital stay were recorded;VAS and JOA scores were observed before and after operation;the incidences of postoperative complications were compared between two groups.
Results: All the patients were followed up for 12 to 24(15.7±5.1) months. Compared with the traditional water flushing group,the operation time of the hydraulic perfusion pump group was shorter[(65.5±21.3) min vs (74.8±19.9) min,t=9.465,P=0.003],and intraoperative blood loss was less[(21.2±12.9)ml vs (27.4±14.1) ml,t=8.331,P=0.012],there was no statistical difference in hospital stay between two groups. Postoperative VAS scores at 1 day,2 weeks and the final follow-up and postoperative JOA scores at the final follow-up of the two groups of patients improved compared with those before operation,but there was no significant difference between two groups (P>0.05). In the traditional water flushing group,the intracranial hypertension occurred during operation and the operation time was forced to shorten in 5 cases,the nerve root adventitia injury in 4 cases,and the postoperative recurrence in 4 cases. No intracranial hypertension during operation was found in the hydraulic perfusion pump group,nerve root adventitia injury occurred in 1 case,postoperative recurrence in 2 cases. The incidence of complication of the hydraulic perfusion pump group was lower than that of the traditional water flushing group.
Conclusion: Both hydraulic perfusion pump and traditional water flushing assisted percutaneous endoscopic lumbar disc herniation can achieve satisfactory clinical results,but the former has shorter operation time,clearer intraoperative vision,less bleeding,and fewer intraoperative and postoperative complications. |
| KEYWORDS:Percutaneous endoscopic lumbar discectomy Therapeutic irrigation Case-control studies |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 关月红,吴健.液压灌注泵与传统水流冲洗应用于经皮椎间孔镜腰椎间盘摘除术的临床研究[J].中国骨伤,2021,34(1):63~67 |
| 英文格式: | GUAN Yue-hong,and WU Jian.Clinical study of hydraulic perfusion pump and traditional water flushing for percutaneous endoscopic lumbar discectomy[J].zhongguo gu shang / China J Orthop Trauma ,2021,34(1):63~67 |
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